Spina Bifida

What is spina bifida?

Spina bifida is a birth defect. It affects a baby’s spine during pregnancy. The baby’s spine does not close completely. This can cause damage to the baby’s spinal cord and nerves. Some babies will have lifelong problems. This includes physical and intellectual disabilities. Pregnancy screening, spinal surgery after birth, and other support helps. There are three forms of spina bifida.

Spina bifida develops in the first few weeks of pregnancy. This is before many women know they are pregnant.

Occulta:

Least serious form

Small opening in the spine

Healthy spinal cord and nerves

Usually diagnosed at an older age because there are no outward signs

Diagnosed with a back X-ray for another health problem

No physical or intellectual disabilities present

Meningocele:

Leaking spinal fluid

Damage to the spinal cord membranes

No major nerve damage

Minor physical disabilities are possible, but low risk

Bowel and bladder control problems are possible

Myelomeningocele:

The most serious form

Leaking spinal fluid

The spinal cord and nerves are moderately or severely damaged near the opening in the spine

Paralysis in the lower part of the body is possible

Bowel and bladder control problems are likely

Doctors look at the size and location of the opening in the spine. Also, they look at the type to determine severity.

Symptoms of spina bifida

Symptoms may never appear in the occulta form.

Meningocele or myelomeningocele forms may have symptoms during a pregnancy screening or at birth.

Pregnancy screening symptoms:

Abnormal protein levels in the mother’s blood. This is measured through an alpha-fetoprotein (AFP) test. It tests the amount of protein the baby is passing onto the mother.

Abnormal protein levels in the amniotic fluid. This fluid surrounds the baby during pregnancy. This is measured through an amniocentesis test.

Abnormal-looking spine during pregnancy ultrasound. This is an imaging test done during pregnancy.

A pregnancy screening may be necessary if:

You have another child with spina bifida.

You have a family history of spina bifida.

You have not been taking folic acid during your pregnancy.

You have certain health conditions (diabetes, obesity).

You take certain medicine for seizures or depression.

Meningocele or myelomeningocele symptoms at birth:

Hydrocephalus (fluid on the brain). This makes the baby’s head look unusually large. The baby’s soft spot on the top of his or her head may bulge.

Muscle weakness in the baby’s feet, hips, and legs

A dimple or patch of hair in a certain spot on the baby’s back. This may suspicion. Muscle weakness and hydrocephalus provide better clues.

What causes spina bifida?

Exact causes are unknown. Genetics and ethnicity (Caucasian and Hispanic) may play a role. However, there are steps to reduce the risk of having a baby with spina bifida. These include:

Take 400 micrograms of folic acid every day during pregnancy. Talk to your doctor about a higher dose if you already have a child with spina bifida.

Talk to your doctor about current medicines you are taking.

Control your diabetes and try to lose weight before you get pregnant.

Avoid overheating your body.

Treat a fever right away with Tylenol or other brands of acetaminophen.

How is spina bifida diagnosed?

Your doctor may test your baby for spina bifida during your pregnancy. This would be if your doctor suspects your baby has spina bifida at birth. Or, if he or she believes you need a pregnancy screening. After birth, your baby’s doctor may order an X-ray, magnetic resonance imaging (MRI), or computed tomography (CT) scan to better check for and determine the severity of spina bifida.

Can spina bifida be prevented or avoided?

Studies show that folic acid can reduce the risk of spina bifida. Folic acid is a vitamin present in women before and during pregnancy. A pregnant woman should take 400 micrograms of folic acid every day throughout pregnancy. This is especially important for unplanned pregnancies. A higher does may be necessary for pregnant women with certain risk factors. This includes obesity, diabetes, depression, or a family history.

Eating foods high in folic acid can help. These include:

Dark, leafy greens

Beans

Peas and lentils

Seeds and nuts

Spina bifida treatment

There is no medicine or cure for spina bifida. People with myelomeningocele and meningocele will likely need treatment. Surgery after birth is a possibility. Some babies can and should have surgery while still in their mother’s womb. This depends upon the type and severity of their condition. Most babies will require surgery 1 to 2 days after birth. Some may have repeated surgeries over the years. Surgery involves a team of specialists.

If surgery does not help, your doctor may refer you to a physical therapist. This person can help your child increase his or her strength and balance. A physical therapist also can teach your child how to use equipment to help with moving independently. This might include leg braces, a walker, crutches, or a wheel chair.

More severe cases may affect your child’s learning and academic performance. Special education resources within your local school district provide support.

Living with spina bifida

Living with spina bifida depends on the location, size, and form your child has. Mild complications are possible, including:

Abnormal nerve sensation

Skin irritation

Latex allergy (a natural rubber)

Severe complications include:

Difficulty eating

Choking

Stomach disorders

Walking

Paralysis

Breathing

Learning and intellectual disabilities

Depression (in teen and adult years)

Hydrocephalus (enlarged head due to fluid on the brain)

Urinary tract infections (UTI’s)

If surgery hasn’t improved your child’s spina bifida, you can help your child learn the use of crutches, a walker, or wheelchair. For intellectual disabilities that affect learning, school support is available. Social service provides can provide assistance to adults with intellectual disabilities.